Hair Loss – What, why, how?

Hello all – This is the second article in a series I’m doing about Alopecia, which is the general medical term for hair loss. As I mentioned in the first article, your hair is a part of the skin organ, so the health of your hair is very much “intertwined” with the health of your skin. And as someone who has spent the last decade and a half helping people with skin problems, I realize that I haven’t talked as much about the issue of hair loss as I should. Especially since Awakening makes a Dead Sea Hair Loss formula! Over the years, I’ve gained some important insights into hair loss and other scalp conditions, and the articles in this series are my way of sharing these insights with you.

We at Awakening have made some very encouraging discoveries about the role of Dead Sea minerals in offering a new kind of alternative treatment for certain types of Alopecia, and I’ll be discussing those discoveries in a later article. I know that many of our female customers have been clamoring for more information about the benefits of using Dead Sea Mud products for menopausal hair loss, and I promise I’ll be going into detail about women’s hair loss in the next article in this series.

For this post, though, I’m going to talk about the different kinds of Alopecia commonly encountered. There are a lot of misconceptions about alopecia, and my sincere hope in this series is to dispel these misconceptions, and at the same time enable you to make informed decisions about how to approach your particular hair loss situation (and avoid the snake oil salesmen).

Everything you ever wanted to know about hair (but were too bored to ask)

How hair grows may not be the most fascinating topic in the world, but knowing the basics can really help you to make good decisions about hair loss treatments. Here’s the *very* quick version: The growth cycle of hair has three phases: “anagen,” “catagen,” and “telogen.” At any given time, 80% – 90% of your hair is in the anagen phase, which essentially means “active growth.” The catagen phase refers to the point at which the hair stops growing. The telogen phase refers to the point at which the hair falls out.

Now, a person with a full head of hair has between 100,000 and 200,000 individual hairs, so the number of hairs in the catagen and telogen phases may be as high as 40,000! In other words, you may very well be “losing a lot of hair” but have nothing going on that would be categorized as Alopecia.

Alopecia often occurs when a high number of hair follicles all enter the telogen or catagen phase of hair growth simultaneously. The thing to realize is that your hair is always going through these stages more or less at random. The difference between normal hair growth and Alopecia is simply that in the normal state, the growing hairs (anagen state) greatly outnumber the hairs in the telogen or catagen stages. With Alopecia, something causes a lot of hairs (usually, but not always, in a given spot on the head) to enter the telogen or catagen stage at once, resulting in hair loss that becomes noticeable.

Types of Alopecia

Androgenic Alopecia
Androgenic (or androgenetic) Alopecia , a.k.a. “male pattern baldness”, was not well understood until recent years, although it has been clear for centuries that baldness is hereditary in nature. Although scientists suspected that a predominance of testosterone was at the root of the problem, new research shows that it is actually a substance called Dihydrotestosterone (DHT), which is a derivative of testosterone. DHT is in a class of hormones called “androgens,” thus the name “androgenic Alopecia.” (Note that this is not the same thing as the “anagen” phase of hair growth, mentioned above.) It appears that it’s not the amount of testosterone that causes this hair loss or thinning, but instead the level of DHT that binds to the hair follicles. The DHT has the effect of shrinking the follicles, which “suffocates” healthy hair.

Female Pattern Baldness?
Until recently, the Androgenic Alopecia was the term used to describe what has been called “female pattern baldness,” but doctors have now come to the conclusion that the condition of diffuse thinning of hair all over a woman’s head is NOT the same thing as male pattern baldness. In an excellent article on WebMD.com, dermatologist Ted Daly claims that doctors “don’t even like to use the term ‘androgenic alopecia’ in women anymore — instead we call it female pattern hair loss — a broader term that encompasses many possible causes, some of which are likely to be directly linked to an excess of testosterone, and some of which are not.”

So although women can experience diffuse thinning of hair starting as early as their teen years, the condition is not directly attributable to genetic causes, as in the case of Androgenic Alopecia. Instead, doctors are now using the term “female pattern hair loss” to describe the thinning of female hair, which includes many different conditions. So one wonders if there is any real value in this term, but for the moment, it’s what we’ve got.

Now, depending on who you talk to, the issue of menopausal hair loss in women – which I’ll be writing a full article on soon – either is or is not considered under the umbrella of female pattern hair loss. Either way, the issue of menopausal hair loss is a very important issue, and one that Awakening’s products can help with.

Telogen Effluvium
Telogen effluvium (TE) is the second most common type of Alopecia, and it occurs when there is a dramatic upward shift from the normal 10%-20% of hair in the telogen phase.

TE usually occurs as the result of a major long- or short-term stress to the body (whether hormonal or otherwise), such as child birth, malnutrition, a severe infection, major surgery, a car crash, or even extreme general stress. TE usually manifests about six weeks to three months after the actual occurrence of stress. This is the kind of Alopecia that can result in losing clumps of hair at a time. Although TE is almost always traceable to a particular event, there are cases with no obvious cause. These are very rare, however. In the case of TE, removing the source of stress usually puts the body back on course to re-grow the hair that has been lost.

The causes of TE are numerous, but as I mentioned above, there is always a link to some kind of significant stress. The most common example of short-term TE is during the period of time right after giving birth. Postpartum Alopecia, as it is sometimes known, is simply a reaction to the shock of such an immense hormonal shift in the body. A huge percentage of anagen-phase hair suddenly shifts into the telogen phase, causing, in some cases, significant shedding. But the hormonal crisis of childbirth is very short lived, so women who experience Postpartum Alopecia will generally see their hair return to normal very quickly.

Some drugs are indicated as a possible cause for TE. Antidepressants are a common source.

Chronic illness or malnutrition are also common causes of TE, as is exposure to many toxins. Chronic illness may lead to TE. A deficiency in hormones such as thyroid can also cause TE.

Anagen Effluvium
Anagen Effluvium occurs when there is a shock to hair in the anagen, or productive phase of the cycle. In this case, as the body is exposed to some substance that shuts down the healthy replication of cells, so the abundant anagen-phase hair dies and falls out without ever entering the telogen phase. The most well-known example of Anagen Effluvium is the hair loss caused by cytostatic drugs used to treat cancer patients in chemotherapy. (Another cause can be the ingestion of certain deadly poisons.)

In the case of chemotherapy, these drugs are used to inhibit rapid cell proliferation, and stop the spread of cancerous cells. However, the cells of hair follicles are some of the most rapidly proliferating, non-cancerous cells the body has, so these drugs almost always cause hair loss. Because the shock to the hair follicles is so sudden, there is no normal transition into the telogen or resting state, and in many cases all hair on the body is lost very quickly. There have been some efforts to lessen the resulting Alopecia from cancer treatments by using what is called “cold therapy.” This is a technique used more commonly in Europe than in the U.S. and Canada and involves covering the scalp with ice packs or a special hood filled with ice water during the period of time that the chemotherapy drugs are being administered. This puts the hair follicles into a kind of “suspended animation” and stops the hair follicles from absorbing the drugs. The apparent downside to this treatment is that this may also prevent any cancer cells that might be in the skin from accepting the drugs.

Two things are worth mentioning in the case of chemotherapy-induced hair loss. First, the loss of hair is almost always temporary. Often people begin to see re-growth of their hair within a month of the chemo treatment. There are some cases, however, where the drugs have a longer lasting effect, and actually change the structure of their hair, resulting in a shift from curly or frizzy hair to straight. Changes in color have also been documented. These effects can be permanent.

Second, there is what cancer patients commonly refer to as the “peculiar sensation” they get in their scalp after chemo treatments. It is described variously as itching, tingling, burning, and buzzing, and can be so constant as to make concentration and relaxation difficult. Although I will discuss this in more detail in a later article, I will mention now that the “peculiar sensation” is one area where Awakening products can help. Our Dead Sea mud product called SCALP has been shown to dramatically reduce this sensation and to support healthy hair follicles so that the return to a full head of hair can be as rapid as possible.

Alopecia Areata
Alopecia Areata (AA) is the third most common form of hair loss, after androgenic Alopecia and telogen effluvium. The lifetime risk for AA is surprisingly high – approximately 2% of the population will experience AA at some time in their lives. Researchers believe AA is an autoimmune response in which a person’s immune system attacks hair follicles, much like with rheumatoid arthritis or psoriasis. In this case the individual’s own immune system attacks hair follicles instead of bone joints. Just why or how AA develops is not clear. The most common AA treatment involves the use of corticosteroids. I’ll discuss Alopecia treatments in more depth in a later article.

Unfortunately, many people with more extensive, long-term AA find the treatments currently available do not work well. For these individuals the only practical answer is a wig and lots of emotional support. It can be depressing not to have hair, especially for children, who don’t want to be different from their classmates at school, and women. In North America and many other countries of the world, you can access a network of support agencies for people with AA. Details are on the National Alopecia Areata Foundation website (http://www.naaf.org).

Check back soon for my next article, which will address the issue of menopause hair loss. I’ll be discussing several key points about hair loss in women, and distinguishing between some of the more common types of alopecia in women.

For more reading about the remarkable benefits of Dead Sea Minerals for your skin (and, thus, your hair!), check out the Dead Sea Section of the main Awakening Mineral Therapies website. See you soon!

2 Responses to “Hair Loss – What, why, how?”

Primary reasons why women get bald or have a excessive hair loss problem are cause by problems, stress and anxiety – specially for pregnant women, they have higher possibility of getting excessive hair loss.

Good comment. Thanks. Post-partum often makes things even more complicated, as the body works to stabilize hormones. Our work at Awakening Mineral Skin Care aims to deploy natural minerals to help at the skin-deep level.

Just want to introduce myself: I’m Rob Hardwicke, the President and Product Master of Awakening Skin Care. The goal of this blog is to be a participatory voice on issues that affect us all when it comes to skin care.
All of us have skin (a profound observation!). All of us are living longer and longer (or at least some of us). Therefore, since we’ll be occupying this skin of ours for a good many years, we might as well make the most of it. This means taking care of our skin. READ MORE ABOUT ROB HARDWICKE